One of the big opportunities in biotech over the coming decades may come from neuroscientists who team up with Buddhists. That might sound odd at first, but it’s no joke. This is one of the big ideas on the radar of Bennett Shapiro, the former executive vice president of worldwide basic research at Merck, who lives in Seattle, and serves as a senior partner with Boston’s PureTech Ventures.
Researchers are beginning to get a stronger sense of physiological differences in the brains of Buddhists who have been practicing mind training techniques like meditation for years, as compared to, say, the average brain of a distracted American, Shapiro says. These insights, based partly on brain imaging tools like functional MRI, are sparking new ideas about how to combine meditation techniques with neurological drugs, offering potential to do a better job of treating mental health problems, he says.
“If you want to think about the future in biotechnology, you would want to think about how you can help people regulate their emotions and attention,” Shapiro says. “If one can employ mind training in combination with pharmacologic therapies, one might be able to enhance their efficacy and thereby relieve the suffering of millions of people.”
Shapiro, 70, a longtime Seattleite who I met at a coffee shop near his house in the Magnolia neighborhood, sees these unusual connections between neuroscientists and Buddhists at close range. He serves on the board of the Boulder, CO-based nonprofit Mind & Life Institute, alongside the Dalai Lama himself and top neuroscientists like Richard Davidson of the University of Wisconsin. The Institute is trying to encourage research beyond the current drug regimens, like with selective serotonin reuptake inhibitors such as Prozac, which Shapiro calls “blunt instruments” aimed at treating the most complex, differentiated organ in nature, the brain.
Even though the current drugs don’t work for everybody, and placebos often do remarkably well in clinical trials, these “blunt instruments” still add up to a lucrative market for drug companies. Pfizer alone generated $6 billion last year from neurology drugs, a 17 percent gain from the prior year, making this a faster-growing product category for that company than cardiovascular disease, pain, or cancer treatments. If drugs could be made that were more effective, presumably the market would get a lot bigger. About one out of every four adults in the U.S. suffer a diagnosable mental disorder each year, according to the National Institute of Mental Health.
But what Shapiro is talking about could go a lot further than just diagnosable mental disorders. He’s thinking much more broadly about combinations of mind training and drugs that can help millions of children and adults. He says this sort of mind-training would be self-initiated and driven, not the coercive, frightening stuff from the movies like “A Clockwork Orange.”
If this is done the right way, Shapiro says, “Think about how people who meditate can control their emotions,” as well as their attention spans, Shapiro says. This could transform the educational system, he says. “Children could be taught all the things they already learn, but also learn skills on how to deal with distractions and regulate their attention.”
No biotech company that Shapiro is aware of, and certainly none of the Big Pharma companies, have decided to take a serious swing at this concept. “This is more of a germ of an idea,” he says.
Global health is another big idea that Shapiro is fully embracing at this later stage of his career. He was eager to chat about the Drugs for Neglected Diseases Initiative (DNDI), a nonprofit in Geneva, Switzerland, where he serves on the board. This organization is pushing to develop six to eight new drugs for the major scourges of the developing world by 2014.
On global health, Shapiro sounded less scientifically audacious to my ear, and more focused on practical realities of how to deliver simple treatments that already exist. The DNDI isn’t fixated on discovering breakthrough drugs with novel ways of working, but instead lists one of its proudest accomplishments as creating a simple fixed-dose combination of existing drugs that costs less than $1, and is given in a simple blister packet that makes it easy for patients to comply with doctors’ orders, and therefore prevent the development of drug resistance.
Experience with the new drug formulation in the Amazon River basin in Brazil, where malaria infections are a part of life, showed that the treatment was able to cut down on incidence by two-thirds, and is now being used by Brazilian national authorities, Shapiro says. Another fixed-dose combination, made for malaria strains in sub-Saharan Africa, has been supported through a partnership with Paris-based drug giant Sanofi-Aventis. About 5 million doses of that drug were delivered in 2008, and that will quadruple to more than 20 million this year, according to the DNDI.
Besides all this nonprofit work, Shapiro spends a lot of time on the boards of for-profits through his role at PureTech. We didn’t talk much about it, although he noted that he was drawn to PureTech partly because it is trying to “bring the spirit back” of the early days of biotech, 25 years ago, when venture capitalists weren’t nearly as cautious as they are now.
This freedom to think about cracking big problems on the frontiers of biology sounded liberating to Shapiro, who spent 13 prime years of his career at one of the world’s top pharmaceutical companies. He walked away with a record of having a hand in the development of 23 new drugs that reached the marketplace, mixed in with the familiar frustrations of working in an industry with more than its share of groupthink and copycats. “One person finds something and everybody else piles on,” he says.
Now, he doesn’t have to run with the pack at all. If he’s anywhere close to the right track with the idea of combining behavior and neurological drugs, or if the anti-malarial drugs start putting a dent in incidence around the world, then he could have something more impressive on his resume than some big-selling drugs he helped develop at Merck.
“This is the best time of my life,” Shapiro says. “It’s fabulous.”
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